What a week! You wait for ages for a focus on the behavioural risk factors for ill-health and then three policy announcements come in a week – obesity on Monday, cycling and walking on Tuesday and food on Wednesday. We can’t claim any credit for the cycling strategy, but the obesity policies build firmly on some of our research.
Important measures in the obesity plan include action to help people lose weight alongside wider prevention policies to halt excess weight gain. The weight management aspects draw on several of our trials which show the effectiveness of weight-loss interventions and to support primary care referrals*. To encourage more effective self-management of weight there is a revamped NHS 12-week weight loss plan, which includes insights from the online weight loss trial we have just completed as part of work with the NIHR Oxford Biomedical Research Centre.
New public health policies include mandating calorie labelling in cafes, coffee shops and restaurants and legislation to limit volume-based promotions (‘buy-one-get-one-free’ type strategies) and restrictions on foods high in saturated fat, sugar and salt in prominent locations in grocery stores. We did some initial work on the effect of promotions in collaboration with the University of Cambridge**, and testing interventions to encourage healthier food purchasing is an important strand of our work as part of the NIHR ARC Oxford and Thames Valley, led by Carmen Piernas.
The headline policy was a ban on advertising foods high in saturated fat, free sugars and salt on TV and online before 9pm. This is heavily based on research by Emma Boyland, at University of Liverpool, which we’ve been championing in recent contributions to the Health Select Committee on childhood obesity and recent House of Lords Committee on Food, Poverty, Environment and Health.
We are also pleased to see a shift in the tone of the policy discourse, recognising people need support to eat healthily and to manage their weight, and in the language being used, building on work by Charlotte Albury.
Meanwhile, on food, the interim report from the National Food Strategy reiterates some of the policy actions in the obesity announcement, but also addresses some of the wider food-related issues caused by poverty. It includes the importance of the nutritional safety net provided by school food, and the guidelines we helped to develop for food provision during lockdown. In the final report from the National Food Strategy, expected next Spring, there will be attention to both food production and consumption to accelerate progress towards healthier and more sustainable diets drawing, I hope, on some of the work from our LEAP programme funded by the Wellcome Trust.
There is still much more to do in all of these areas, but this week we can at least take a moment to celebrate some real impact from our research programmes.
Screening and brief intervention for obesity in primary care: a parallel, two-arm, randomised trial. Aveyard et al. Lancet 2016
GP-delivered brief weight loss interventions: a cohort study of patient responses and subsequent actions, using conversation analysis in UK primary care. Albury et al. British Journal of General Practice 2018
What Makes Opportunistic GP Interventions Effective? An Analysis of Behavior Change Techniques Used in 237 GP-Delivered Brief Interventions for Weight Loss. Bourhill et al. Annals of Behavioural Medicine 2020
Price promotions on healthier compared with less healthy foods: a hierarchical regression analysis of the impact on sales and social patterning of responses to promotions in Great Britain. Nakamura et al. American Journal of Clinical Nutrition 2015
Grocery store interventions to change food purchasing behaviors: a systematic review of randomized controlled trials. Hartmann-Boyce J et al. American Journal of Clinical Nutrition 2018